Getting Diagnosed with Dementia: What Does My Loved One Need?

Dementia is a degenerative condition where an individual’s cognitive abilities (e.g. memory, thinking, processing, language abilities, problem solving and so on) and functioning decline at a faster rate than what is considered to be normal. It affects 1 in 10 Singaporeans aged above 60 and half of those above 85, and is considered a common condition among seniors. 

Understanding Dementia diagnosis and its symptoms 

There are different types of dementia, the most common and most well-known one being Alzheimer’s Disease. Symptoms of diseases include, but are not limited to:

• Memory loss
• Depression
• Confusion 
• Sudden withdrawal from social activities and engagements 
• Personality and mood changes 
• Difficulty carrying familiar tasks 
• Poor judgment and perception
• Problems with language and communication 

Different types of dementia will present with different symptoms. As it is a condition which affects the brain, individuals with dementia experience decreasing ability to function independently in everyday life. 

Dementia is usually diagnosed by a doctor who is qualified in this condition. The doctor will run some assessments and tests on the individual, and may order for brain scans known as CT scans or MRIs. These all help to determine whether or not someone may have dementia. 

You can find out more about Dementia through Homage’s e-book, which you can download for free.  

Dealing with the Diagnosis 

When someone is diagnosed with dementia, there is a whole barrage of emotions to take in. Ranging from relief of finally having a label to understand what is affecting them, to grief and fear of the effects of this condition, these feelings are difficult to cope and deal with. Family members of individuals with dementia also have to consider what this condition would mean for them as well. In dealing with the diagnosis, the immediate considerations to support someone with dementia would be in accepting the diagnosis, dealing with conflicting emotions, and also tapping on pre-existing resources to alleviate some of the load. 

1. Accepting the diagnosis 

Acceptance is not an immediate affair. Rather, grief is usually the first immediate response of individuals and their loved ones to the diagnosis. After all, the diagnosis marks the end of a life once known, and the start of changes in time to come. It is perfectly alright to take time to come to accept the diagnosis.

It is not helpful to rush toward acceptance, nor pressure someone into it. Everyone has their unique journey to walk through, and it is not wise to impose what we believe to be right on others, as it may lead to unnecessary stress.

In acceptance, what is more important is that the individual feels and knows he or she is supported by their loved ones in this process. Family members can help to provide reassurance and support by being patient, flexible and open in communication with the individual. This all speaks to the person with dementia that he or she is not alone in facing this. 

2. Dealing with conflicting emotions

There are varying emotional responses upon hearing the diagnosis of dementia, both for the family members of persons with dementia, and the individuals with dementia themselves. There is no one way to first respond to the diagnosis, nor is there a right or wrong way. 

It is essential at this point that as your loved one’s support, you are there to listen to and process these feelings with them. Even if it may be difficult to deal with fluctuating emotions, we, as their nearest and dearest, are most helpful when they see us being there for them through all situations. 

Dealing with conflicting emotions means that some individuals may not be ready to speak about the dementia diagnosis, and may want to live life normally, insisting on carrying through with their usual routines themselves.

Give them some time to process, and eventually, gently broach the topic of the diagnosis with them when they are ready. Listen and reply thoughtfully in a non-judgemental manner, jot down questions you may not have the answer to, and note down their fears, insecurities or thoughts regarding the diagnosis.

You can help them to cope better with their emotions by planning ahead to find answers to questions, reflecting on their fears, and finding some feasible solutions or ways to manage them. 

As a loved one and caregiver of a person with dementia, you may feel conflicting emotions as well – the frustration of having to take care of someone who was once able, and yet sadness while watching a loved one slip away into the condition can be mentally trying as well. Have an outlet you can rely on, such as journaling, taking out personal time for self-care, or even hiring caregiving services to take a break as well.

Financial subsidies and resources in Singapore for Persons with Dementia 

Though the journey is long and difficult, there are more resources available nowadays to help persons with dementia and their families. From direct caregiving services to financial help or information portals, individuals and family members or carers can tap on these resources to aid in the journey. 

1. Technology

Assistive devices such as sensor lights or alarms, or GPS trackers, are some tools which can help an individual with dementia increase their own independence in activities of daily living. Moreover, these could help to ease some of the stress of caregivers and family members, who are likely to be fraught with worry when the person with dementia is not in sight and as the condition deteriorates. 

2. Financial aid

The Government has provided several funds and grants to aid with alleviating the financial costs of dementia. Some of these are: 

MediShield Life

MediShield Life is a basic health insurance plan which helps to pay for large hospital bills and selected outpatient treatments, such as dialysis and chemotherapy for cancer. It provides lifelong coverage for all Singaporeans, regardless of their age or pre-existing/existing health condition.

Community Health Assist Scheme (CHAS)

Clinics under the CHAS scheme can provide subsidized treatment to eligible patients. The beneficiaries of CHAS are usually the needy, elderly and disabled Singaporeans. 

Means Testing for Healthcare Services

Financial assistance can be provided for patients who require healthcare services. This is determined through a Means Testing framework. 

Caregiver Training Grant (CTG)

A $200 fund is available to caregivers or helpers of persons with dementia who wish to take approved courses for caregiving. There are courses available for caregivers on dementia care. 

3. Home assistance 

Extra help around the home can be helpful for persons with dementia and their family members, at different stages of the condition. You may choose to hire a domestic helper or engage professional caregiving services for your loved one. 

Domestic helper

A helper is probably one of the first options in most people’s minds when they think of extra help. With a live-in helper, they can help with the chores. When doing so,  do consider the costs of hiring a helper in Singapore, as well as the level of expertise the domestic helper has when it comes to handling persons with dementia. Hiring a domestic helper can sometimes be a lengthy process. In some cases, where on-demand care is needed, you may consider professional caregiving services as well. 

Caregiving services

If a live-in helper is something the family nor the person with dementia is comfortable pursuing, why not consider caregivers? Unlike helpers, caregivers work for a stipulated amount of time and do not need to stay with the family unless requested. Sometimes, the cost of a caregiver can be more affordable than hiring a live-in helper, depending on the situation. Also, there is flexibility in hiring a caregiver versus a helper, as you can choose from a short-term versus a longer-term commitment. 

Different caregivers are trained differently, so picking one with dementia care experience or training would be ideal. At Homage, caregivers have undergone training at Alzheimer’s Disease Association (ADA) and are more specialized to provide better care for you and your loved one. Moreover, they can provide companionship and engagement, beyond just support of activities of daily living. 

There are different types of care options available, ranging from by the hour per day (Pay As You Go) to a caregiving package calculated by the number of hours of care per month (Prepaid Package). Here are the differences in brief: 

Depending on your needs, if you do know you need longer-term support for your loved one and want to avoid the hassle of having to schedule on a daily basis, you can consider the Prepaid Package for a one-time payment.

How to Plan for Dementia Care for Your Loved Ones 

So how can we plan for dementia care for our loved ones?

Let’s take a look at Stacy*, a regular 9-to-5 office worker who is living with and caring for her mother who has dementia. Stacy’s mother, Mdm Phua*, is in the moderate stages of dementia, which means she requires increased support and help in her daily routine tasks and in communicating with others.

Compared to before, Mdm Phua has frequent mood swings and tries very hard to remember happier times in her past as a store owner in a coffee shop, but gets frustrated as she finds she is starting not to be able to remember much of it in vivid detail. 

Stacy works three full days at the office, and two full days from home, a flexible arrangement agreed upon by her supervisor at work, who knows of her family situation. She usually cares for her mother at night. In the day, her brother, Harry* who works freelance comes over to care for Mdm Phua, but oftentimes is working and sometimes has to leave the house to meet clients.

Likewise, when Stacy is at home, she has to take work calls and reply to urgent requests and deadlines. Mdm Phua often has outbursts directed at her children, blaming them for not giving her undivided attention. This has taken its toll on both siblings, who often bicker due to the increased care needs of Mdm Phua and also the tension from the emotional changes within the family. 

Stacy and Harry have discussed and opted for the Prepaid Package of 40-hours at Homage, to support their mother and also their caregiving efforts. They have decided that they will need five hours of dedicated home care for Mdm Phua per day, while they can continue to care for her in the remaining hours. This can last the family for about eight sessions. The caregiver has recommended a balance of personal care and emotional care for Mdm Phua as shown in the image above. 

With home care, Stacy and Harry can breathe a sigh of relief and focus on their work for a few hours. Mdm Phua also benefits from the focused attention from the caregiver, and does not feel so lonely during the day. Her outbursts have lessened as well. 

When someone we care for is diagnosed with dementia, what they likely need is our support and to know that we are walking this journey with them. Consider their needs, and your needs, and tap on the available resources – after all, helping yourself is one of the crucial steps in supporting your loved one as well. 

*Fictional characters for the purposes of illustration

Caring for your loved one with Dementia

While there is no cure for dementia, there is robust support available for persons with dementia here in Singapore. Get the appropriate help and support you need to give your loved ones the best care they deserve. You are not alone in this journey.